Small fontanel in newborns

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Among many parents, a variety of arguments go around the fontanel of a child. At the same time, for some mothers, such a definition for some reason causes some concern. It’s even scary to touch this place - suddenly, due to careless movement, you can injure the baby ?! But not every woman understands exactly what a large or small fontanel means. Yes, there are several of them in newborns. But what is he? Let's try to understand this seemingly complicated term.

Anatomy lesson

In order to fully reveal the definition of the fontanel (it is also called the crown), it is worth plunging into anatomy. The human skull is represented by several bones that are interconnected by sutures. These are zigzag, jagged and uneven lines. But this is already in adults.

In the period of intrauterine development, everything is just beginning to develop. The bones of the skeleton are formed in the form of platesfrom dense webbed fabric. Subsequently, cartilage tissue is formed, which, in turn, is then replaced by bone.

The ossification of the upper and lateral parts of the skull occurs differently than the formation of the long tubular bones of the arms and legs. There is no cartilage stage here anymore. In other words, ossification points begin to appear in the center of each membranous plate. Then they spread in all directions to the edges, covering more and more surface.

Actually, as a result of this, a large and small fontanel is formed in newborns. This process occurs throughout the entire period of intrauterine development, and by the time of the onset of childbirth, almost the entire skull of the child is represented by a bone surface. At the same time, this biological tissue differs from that which is inherent in the skull of an adult. In a newborn baby, this is a thin and elastic layer, which is penetrated by a large number of blood vessels.

Mothers should not panic when doctors feel the fontanel on their baby's head. Despite the fact that this "breathing" area seems vulnerable, in reality you should not be afraid of this. This thin fabric is at the same time quite dense and strong despite its deceptive appearance. Therefore, the manipulations of doctors in no way harm children.

Opening the definition

Now we get to the point of the large and small fontanels. But first, you should once again make sure of the perfection of Mother Nature. But not all of its secrets regarding the origin of man are known to us. But something for usopen. It is about preparing the child for labor. Nature took care of it. The bottom line is that some areas of the bones at the time of the birth of the child remain in the form of membranous plates. But this is nothing more than a fontanel.

In some cases, the plates may increase, which is evidence of prematurity or indicates a violation of the intrauterine ossification process. In addition, this may also be the cause of the development of congenital hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain).

As the child develops, both the large and small fontanels in newborns (including the lateral areas) harden and become a continuation of the bones of the skull. In the language of doctors, this is called the closure of the crown, which is partly true. At the same time, the pace and timing of this process indirectly indicate the normal development and well-being of the baby.

How many fontanelles does a child have?

By the time the baby is born, there are 6 of them - two unpaired (large and small) and the remaining 4 on the sides of the head. Paired records are:

• Wedge-shaped fontanel. It is located in the temporal zone: in the place where the frontal, parietal, sphenoid and temporal bones converge on each side.
• Mastoid crown. Its localization is the area behind the ear, or rather, where the occipital, temporal and parietal bones connect.

But among them all, the most important are unpaired membranous plates (about them a little later). As for the rest, they overgrow duringdays and weeks after the baby is born. But why do you actually need a large and small fontanel? This is exactly what will be discussed in the following sections.

Functionality

Here you can once again marvel at our nature. The formation of fontanelles does not just happen. First of all, it is worth noting that by the time the baby is born, the hardened bones of the skull can not only bend, but also shift, which allows it to adjust to the dimensions of the female pelvis during the period of advancement through the birth canal.

As a result, the risk of injury to the mother and her baby is markedly reduced. For this reason, the newly appeared head of the newborn looks deformed. However, there is no need to worry about this, because already during the first days of a baby's life, his skull takes on a normal shape.

Second point - soft, pliable, elastic and springy webbed plates can serve as a kind of shock absorber and airbag when a child hits his head or falls. As statistics and life experience show, most cases of head injuries occur in the first two years of a child's life. In other words, at a time when Temechko is just closing.

And when does a small fontanel on the back of the head (or front) overgrow? We will certainly touch on this issue, but a little later, but for now it is worth considering another equally important function. The role of the fontanel is also reduced to the fact that its presence makes it possible to avoid possiblebrain overheating. But the process of thermoregulation in babies has not yet been properly established and they are not yet able to give off heat, and do it quickly if necessary.

For example, in case of an increase in body temperature. In such a critical situation, the fontanel is a real salvation. After all, it is not for nothing that he has a thin fabric, and, in fact, due to this, excess heat is passed through it.

Small gauge

Now it's worth a little more detail on the crown of a miniature size and understand which bones of the skull form a small fontanelle. Its location is at the back of the head, and for this reason it is also called the back. As a rule, in babies, it closes completely by the second or third month of their life. For this reason, in the future, pediatricians simply stop paying attention to it, shifting their gaze towards the anterior fontanelle.

At the same time, cases when the elastic plate is closed before the baby is born are not so rare. Often it is palpable in premature babies or babies born prematurely. In addition, there is evidence that no more than a quarter of full-term babies are born with an open crown.

As for the size, "small caliber", that's why it's called. After all, the dimensions of a small fontanel are usually no more than 5 mm.

Large Caliber

As for the “large caliber” crown, its localization is the area where two frontal and two parietal bones meet. It is he who is also called the anterior or parietal (from the bone of the same name). Among all the fontanelles on the headchildren, it is he who is the largest, but also the most significant.

In addition, it is easy to detect even with the naked eye, which causes concern for most parents. In addition, due to the size of the fontanel, it closes the very last, when the others are already completely overgrown. But again, this is where its functionality lies.

In its shape, the anterior crown resembles a rhombus, while the smaller one looks like a triangle (we already know where the small fontanel is located). Moreover, it is clearly noticeable that it is in this place that the fabric is very soft. Against the background of the hardened bones of the skull, the rhombus stands out noticeably. But besides this, the temechko can perform various actions:

• pulse;
• sink;
• bulge;
• take on the wrong shape.

And when doctors in a conversation during the examination of a child mention that the fontanel is overgrown early or closes for a long time, they mean exactly the big plate.

Temechka dimensions

Since all other fontanelles (with the exception of the large one) close faster, we will henceforth consider the anterior segment due to the same high significance. At the time of the birth of a child, its dimensions vary from 22 to 35 mm (the dimensions of the small fontanel are already known to us). Deviations of a few millimeters up or down should not be evaluated as a pathology.

But it should be borne in mind that the brain of a born child grows rapidly during the first 2-3 months of his life. For this reason, duringexpansion of the skull bones, including interosseous sutures, the fontanel may slightly increase. At the same time, this cannot in any way be associated with the growth of this area; all this is mainly due to a change in the shape of the crown. In the following days, it begins to decrease.

The table below shows the average size of the fontanel depending on the age of the child (by months).

Age of newborn (months)	Fannel size (mm)
Up to 1	25-28
1 to 3	23-25
3 to 4	20-22
From 4 to 6	18-20
From 7 to 12	12-17
From 11 to 12	6-9

Determine whether the size of a large or small fontanel in a baby is within the normal range, or whether this can be considered a pathology, only a doctor is capable of. To do this, he conducts calculations using a special formula. In this regard, parents should not judge only by the data from the table above, they are given as an example. However, if discrepancies are found, you can contact a specialist for advice.

Closing dates

As for the timing of the complete closure of the anterior crown, here, due to the various criteria for the development of children, everything is due to the individual characteristics of the young organism. And in this regard, these indicators in children differ from each other.

As pediatricians note, in contrast to the closing period of a small fontanelle, a large crown grows much more slowly. It can take from 3 months to 2 years for its complete overgrowth. As you can see, this interval is quite extensive, and any closure that occurred during this interval should be considered the norm. And judging by numerous observations, this process ends closer to the age of two, or a little later. Moreover, in boys it proceeds much faster than in girls.

However, if the closure of the anterior elastic “membrane” of the baby occurred much earlier or later than the mentioned period, it becomes necessary to examine him. Only in this case, the process should not be regarded as unfavorable or pathological. There are a large number of examples when it took 3 years for children to completely close the crown of the head. And yet they remained perfectly he althy.

And when does the small spring close? Often, by the time the baby is born, it is already overgrown. But if its presence is still detected, then a complete closure will occur within the next two or three months.

Fetal position relative to the reproductive organ

When analyzing the topic of fontanelles, one more important point should be considered, which concerns determining the position of the fetus in the cavity of the reproductive organ. Actually, for this purpose, certain studies are carried out during the entire period of bearing a child. But inespecially they are important for the period of the III trimester and by the time of labor activity.

In this case, depending on the type of presentation of the fetus, the way it will be born will depend. And if it is longitudinal, that is, the axes of the uterus and the child coincide, then childbirth can take place naturally. Experienced specialists can determine this by the position of the small fontanel - on the left, in front, when viewed from the exit of the female pelvis. It also indicates occipital presentation. But the transverse or oblique position of the child in the cavity of the reproductive organ is already a pathology.

Fortunately, the optimal presentation is more common - in 99.5% of cases, the remaining 0.5% of births occur in oblique or transverse presentation of the fetus. And it is worth noting that the position of the child, which does not correspond to the norm, is often a direct indication for a caesarean section. In a pathological situation, there are certain obstacles to the birth of a child. Therefore, the appropriate procedure is assigned.

In addition, it is important not only the position of the child in the cavity of the reproductive organ in relation to the axes (of him and the mother), it matters what exactly is directed towards the entrance to the woman's pelvis:

• head;
• buttocks (breech presentation);
• buttocks legs (mixed presentation).

The last two cases are of the pelvic type, which, in turn, is regarded as a pathology. In this case, it may be associated with a number of complications, including late miscarriage. Therefore, if during the next scheduled examination of a pregnant woman (closer to childbirth) she hears that the small fontanel is on the left, then the child is in the only correct position.

Soon overgrowing of the crown

It is unlikely that parents are able to determine that their child's fontanel closes early, or that it is too small. Another thing is the doctor. And if he comes to this conclusion, he will certainly evaluate the general condition of the child. Early overgrowing of an elastic and at the same time dense area in newborns may indicate a number of pathological signs.

There are very dangerous diseases and no less severe disorders among babies, which just manifest themselves with similar symptoms. But accordingly, in addition to the early closure of the fontanel, other characteristic signs appear that indicate a particular problem. These may include the following cases:

• Craniosynostosis. The pathology of bone tissue in children is quite rare and just occurs against the background of early overgrowth of the crown. This causes an increase in intracranial pressure, deformation of the head, and also leads to impaired hearing or vision. Pathology can be congenital or acquired.
• Microcephaly. The small size of a large fontanel may indicate the development of this pathology. In this case, the baby's head is pathologically reduced, including the brain itself. As a result, babies lag behind in development. The provoking factors of the disease include congenital rubella or herpes virus infection.
• Leukomalacia. Here is the brain tissuemitigated by exposure to congenital diseases (syphilis).

Fortunately, such problems are rare.

At the same time, if the crown closes rapidly, but the parameters of the child's head correspond to his age, and his he alth is good, then this should not be regarded as a pathology. Perhaps, here, too, the reason that a large or small fontanel closes faster than expected lies in the individual characteristics of the young organism. Then there is simply no reason to worry.

Therefore, if during the examination of the child, parents hear from the doctor the phrase that the fontanel quickly overgrows, but does not focus on his condition, then you should not be afraid.

Why doesn't the crown grow?

Besides the situation given above, another case may arise, and exactly the opposite - the crown remains open. What could be the reason? But in many forums, parents often discuss this point. If the fontanel does not close when the child is one or two years old, it is worth remembering that there were cases of its overgrowth even at the age of three. Moreover, this did not have any effect on the development of babies. In addition, in each case, the timing of the closure of a large or small fontanel is purely individual.

At the same time, the possibility of some disease should not be ruled out either. And the fact that the temechko does not overgrow may indicate the development of pathology:

• rickets;
• disruption in the work of phosphorus-calcium metabolism and the metabolic process;
• congenital skeletal disease;
• hypothyroidism;
• Down syndrome;
• achondrodysplasia.

Such conditions are not limited only to an open crown, respectively, other manifestations can be observed. Assessing the size of the fontanel in a child, you should first of all pay attention to how his skull grows. It is also necessary to take into account the general condition of the baby.

And if the child is not bothered by anything, he eats well, sleeps well, there are no developmental disabilities and other he alth problems, then parents should not panic. In this case, the size of the crown plays a secondary role. To exclude the possibility of pathology in relation to a large or small fontanel, it is worth visiting a doctor who, in which case, will dispel or confirm all fears.

In addition, until the child is one year old, he must undergo scheduled examinations, which will allow timely detection of any violations. Therefore, parents in any case should not have cause for concern. And instead of panic, it is better for them to fully engage in their baby, which will only benefit everyone.